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目的探讨产科急性弥散性血管内凝血(DIC)的早期诊断和正确的治疗方法。方法回顾性分析12例DIC患者的临床资料。结果均有明确的诱因,重度子痫前期7例,其中合并胎盘早剥胎死宫内5例,伴有胎儿宫内窘迫1例和双胎剖宫产术后大出血1例,单角子宫畸形伴完全性前置胎盘1例,死胎剖宫产及死胎引产后各1例,妊娠期急性脂肪肝胎死宫内1例,围生期心肌病剖宫产术后1例。全部治愈,宫腔纱布填塞5例,成功4例,子宫切除2例;胎儿存活5例。结论早期明确诊断,及时祛除病因,输注大量新鲜血液、冷沉淀、血小板及血浆等,宫腔纱布填塞,必要时子宫切除是抢救DIC的有效方法。
Objective To investigate the early diagnosis and correct treatment of obstetric acute disseminated intravascular coagulation (DIC). Methods The clinical data of 12 patients with DIC were retrospectively analyzed. The results were clear incentives, severe preeclampsia in 7 cases, of which 5 cases were combined with placental abortion fetus in the womb, accompanied by fetal distress in 1 case and twin cesarean section after bleeding in 1 case, single angle uterine malformation 1 case of complete placenta previa, 1 case of stillbirth after cesarean section and stillbirth, 1 case of acute fatty liver during pregnancy and 1 case of cesarean section after perinatal cardiomyopathy. All cured, uterine gauze packing in 5 cases, 4 cases of success, 2 cases of hysterectomy; fetal survival in 5 cases. Conclusion Early diagnosis, timely removal of the cause, infusion of large amounts of fresh blood, cryoprecipitate, platelets and plasma, uterine gauze packing, if necessary, hysterectomy is an effective method to rescue DIC.